THE PHARMACOLOGICAL EFFECT OF SODIUM-PHOSPHATE AFTER ABSORPTION FROM THE PERITONEAL-CAVITY

Hyperosmolar solutions are frequently used in clinical practice for en emas. In a review of the literature we found 43 published cases of sev ere complications connected with the use of hyperosmolar enemas. The a bsorption of sodium phosphate led to a raise of the temperature up to 41.1 degrees C, massive acidosis and electrolyte disturbances with hyp ocalcemia and hypernatremia. The clinical picture was dominated in mos t of the cases by somnolence or coma. In our experiment the absorption of sodium phosphate from the peritoneal cavity of rats led to similar clinical symptoms and - depending on the amount of sodium phosphate a bsorbed - to the death of the animals. Hypovolemia, hypernatremia, hyp ocalcemia and a direct toxic effect of phosphate on the kidneys is res ponsible for the complex mode of intoxication. Sodium phosphate soluti ons should not be used in patients with inflammatory bowel disease wit h a high risk of laceration of the mucosa or perforation of the bowel.